Genetic modifiers of response to glucose–insulin–potassium (GIK) infusion in acute coronary syndromes and associations with clinical outcomes in the IMMEDIATE trial

Modifiers of response to glucose, insulin and potassium (GIK) infusion may affect clinical outcomes in acute coronary syndromes (ACS). In an Immediate Myocardial Metabolic Enhancement During Initial Assessment And Treatment In Emergency Care (IMMEDIATE) trial’s sub-study ( n =318), we explored effects of 132 634 genetic variants on plasma glucose and potassium response to 12-h GIK infusion. Associations between metabolite-associated variants and infarct size ( n =84) were assessed. The ‘G’ allele of rs12641551, near ACSL1 , as well as the ‘A’ allele of XPO4 rs2585897 were associated with a differential glucose response ( P for 2 degrees of freedom test, P 2df ⩽4.75 × 10 -7 ) and infarct size with GIK ( P 2df